Provider Demographics
NPI:1659854727
Name:SALIM, KHADIJA (MA, CCTP)
Entity Type:Individual
Prefix:
First Name:KHADIJA
Middle Name:
Last Name:SALIM
Suffix:
Gender:F
Credentials:MA, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W UNION BLVD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3732
Mailing Address - Country:US
Mailing Address - Phone:484-347-4350
Mailing Address - Fax:
Practice Address - Street 1:701 W UNION BLVD UNIT 2
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-3732
Practice Address - Country:US
Practice Address - Phone:484-347-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor